KARACHI: There is nothing scarier than Exorcist-style projectile vomiting from a baby who has soiled his diaper so many times in the day that he has actually lost weight. These are the two most marked symptoms of ‘gastro’ that has hundreds of mothers across the province up night after night this summer.
Apart from unclean drinking water, there are other causes of gastroenteritis. “One of the reasons is a virus, Staphylococcus, which produces the Staphylococcal toxins that are a common cause of food poisoning, as it can grow in improperly stored food,” said Dr Durre Samin Akram, a professor of paediatrics and chairperson of HELP. When food is not refrigerated properly, many bacteria grow that produce the toxins.
Another often overlooked cause behind the gastro outbreak is the lack of hand hygiene. “Our environment does not help as it carries a lot of viruses,” explained Dr Asad Ali, a paediatrician at the Aga Khan University Hospital (AKUH). Children eat dirt, touch anything and everything and put unclean materials in their mouth, which exposes them to the bacteria and viruses in the air.
“Keeping your hands clean is vital,” claimed Dr Ali.
According to Dr Zein Ally, a paediatrician at the Ziauddin hospital, babies on formula milk are more exposed to gastro threats, while breastfeeding infants are at a lower risk.
Nearly 250,000 children, under the age of five, die of gastroenteritis and diarrhoea every year. “This is one of the top three reasons behind the high infant mortality rate in Pakistan,” said Dr Ali, adding, “The number one cause of children hospitalisation in AKUH is diarrhoea and dehydration.”
As gastroenteritis is caused by water- and food-borne bacterial infection that is transmitted through eatables, drinking water and water used for cooking has to be clean. Doctors also advise to keep cooking areas clean as many of the bacteria grow in those areas.
Even in rural Sindh, especially Sukkur and its surrounding areas, an average of 30 people are being admitted to hospital a day with complaints of gastro- and diarrhoea-related diseases. There are also reports of the situation getting worse as hospitals cannot provide clean drinking water to patients.
To deal with this potentially fatal disease, doctors now are planning to change their approach. “As gastro causes intense dehydration, we were always just focusing on rehydration of children,” explains Dr Ali. “But now we are trying to direct ourselves towards prevention methods. We are studying and finding out the specific germs that cause gastro so that we can develop a vaccine.”
Giving Oral Rehydration Salts (ORS) to gastro-infected children is still the cornerstone of the cure, but doctors want a more long-term prevention mechanism.
It has been globally established that rotavirus is the most common cause of gastroenteritis. So now doctors want to encourage the use of the rotavirus vaccine. In 2006, effective rotavirus vaccines were introduced. In Karachi, the vaccine is readily available but it has its share of problems. “It costs about Rs4,000 for one dose and two doses are needed. The masses cannot afford Rs8,000. Also, we can only give the vaccine to children who are five months old or younger,” explained Dr Ali.
About three months ago, the US government had banned the vaccine as they had discovered another virus in it. But after tests, the government lifted the ban saying that they could not find any harmful elements in the virus.
“It is myth that children should not eat or drink during diarrhoea. Even if they are vomiting and throwing up everything they consume, parents should keep offering one or two ounces of water or ORS every 10 minutes,” said Dr Ali.
According to doctors, keep your hands clean and increase the liquid intake of children to keep them safe.
Published in the Express Tribune, June 4th, 2010.
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